Volunteer Parental Consent & Liability Form
*for volunteers under 18 years of age.
I, in consideration of the opportunity to participate in Soccer Nights and other Vineyard Community Offerings initiatives conducted jointly by the Cambridge Community Fellowship Church, Cornerstone Church, Hope Fellowship Church, Pentecostal Tabernacle, and Vineyard Christian Fellowship—Greater Boston (hereinafter jointly referred to the “Cambridge Youth Collaborative”), the City of Cambridge, the City of Medford, the Cambridge Police Department, Federal Management Company (“Fresh Pond Apartments”), Mystic Place/Winn Residential, Redemption Hill Church, Seven Mile Road, Redemption Hill Church, and the Charles River Church during the weeks of June 18, 2013 through June 18, 2014 hereby agree and acknowledge as follows:
1. I understand that participation in Soccer Nights and other Vineyard Community Offerings initiatives involves potential exposure to physically dangerous situations and may involve unavoidable risk of injury to participants or damage to property.
2. In consideration of the opportunity for my child to participate in Soccer Nights and other Vineyard Community Offerings initiatives, I agree to hold harmless and indemnify the Cambridge Youth Collaborative, the City of Cambridge, the City of Medford, the Cambridge Police Department, Federal Management Company (“Fresh Pond Apartments”), Mystic Place/Winn Residential, Redemption Hill Church, Seven Mile Road, and the Charles River Church and their employees, volunteers, agents, successors, heirs, estates, executors, administrators, and assigns from any and all claims, demands, actions, damages, and liabilities whatsoever which may directly or indirectly result from or be related to any loss, damage, or injury that may be sustained by my child or sustained by any other person or property, in connection with my child’s participation in Soccer Nights and other Vineyard Community Offerings initiatives.
3. I further agree to release and forever discharge the Cambridge Youth Collaborative, the City of Cambridge, the City of Medford, the Cambridge Police Department, Federal Management Company (“Fresh Pond Apartments”), Redemption Hill Church, and Seven Mile Road, their employees, volunteers, agents, successors, heirs, estates, executors, administrators, and assigns from all such claims, demands, actions, damages and liabilities whatsoever, which I may have, on behalf of my child whether foreseen or unforeseen, on account of my child’s participation in Soccer Nights and other Vineyard Community Offerings initiatives.
4. This release and discharge shall be binding upon the successors, heirs, estates, executors, administrators, and assigns of the undersigned.
5. I certify that, to the best of my knowledge, my child has no medical, psychological, or physical conditions that could interfere with his or her safety in Soccer Nights and other Vineyard Community Offerings activities and that I am willing to assume and bear the costs of all risks that may be created, directly or indirectly, by any such condition.
6. In the event of illness or injury, I hereby authorize representatives of the Cambridge Youth Collaborative, the City of Cambridge, the City of Medford, the Cambridge Police Department, Federal Management Company (“Fresh Pond Apartments”), Redemption Hill Church, Seven Mile Road, and the Charles River Church to act for me according to their best judgment in any emergency requiring immediate medical attention, and hereby grant the right to take appropriate action for my child’s health and safety and to obtain any necessary medical assistance. I understand that the directors & coaches of Soccer Nights and other Vineyard Community Offerings initiatives, or anyone associated with the Cambridge Youth Collaborative, City of Cambridge, the Cambridge Police Department, Federal Management Company (“Fresh Pond Apartments”), Redemption Hill Church, Seven Mile Road, and/or the Charles River Church will not assume responsibility for any medical or dental expenses incurred as a result of participation in this program, and those expenses shall be borne by me, as parent/guardian of my child, the registrant.
7. I give my consent to the Cambridge Youth Collaborative, the City of Cambridge, the City of Medford, the Cambridge Police Department, Federal Management Company (“Fresh Pond Apartments”), Redemption Hill Church, Seven Mile Road, and the Charles River Church to photograph, film, and/or use a photographic or digital reproduction of my child, to identify my child by name and/or to quote or record statements made by my child, for any editorial, promotional, or advertising purposes. I waive any right to inspect or approve the finished version(s). The Cambridge Youth Collaborative, City of Cambridge, the Cambridge Police Department, Federal Management Company (“Fresh Pond Apartments”), Redemption Hill Church, Seven Mile Road, and the Charles River Church and those who are authorized shall have the rights to reproduce, distribute, and display publicly, including on the Internet— photographs, film, videotape, statements, and quotes covered by this release, and to prepare derivative works. I understand that the Cambridge Youth Collaborative, the City of Cambridge, the City of Medford, the Cambridge Police Department, Federal Management Company (“Fresh Pond Apartments”), Redemption Hill Church, Seven Mile Road, and the Charles River Church are not responsible for unauthorized duplication or use by third parties.
8. I acknowledge that I have read and fully understand this Agreement and Consent Form and that I have signed voluntarily on the electronic Soccer Nights volunteer registration form.
1. I understand that participation in Soccer Nights and other Vineyard Community Offerings initiatives involves potential exposure to physically dangerous situations and may involve unavoidable risk of injury to participants or damage to property.
2. In consideration of the opportunity for my child to participate in Soccer Nights and other Vineyard Community Offerings initiatives, I agree to hold harmless and indemnify the Cambridge Youth Collaborative, the City of Cambridge, the City of Medford, the Cambridge Police Department, Federal Management Company (“Fresh Pond Apartments”), Mystic Place/Winn Residential, Redemption Hill Church, Seven Mile Road, and the Charles River Church and their employees, volunteers, agents, successors, heirs, estates, executors, administrators, and assigns from any and all claims, demands, actions, damages, and liabilities whatsoever which may directly or indirectly result from or be related to any loss, damage, or injury that may be sustained by my child or sustained by any other person or property, in connection with my child’s participation in Soccer Nights and other Vineyard Community Offerings initiatives.
3. I further agree to release and forever discharge the Cambridge Youth Collaborative, the City of Cambridge, the City of Medford, the Cambridge Police Department, Federal Management Company (“Fresh Pond Apartments”), Redemption Hill Church, and Seven Mile Road, their employees, volunteers, agents, successors, heirs, estates, executors, administrators, and assigns from all such claims, demands, actions, damages and liabilities whatsoever, which I may have, on behalf of my child whether foreseen or unforeseen, on account of my child’s participation in Soccer Nights and other Vineyard Community Offerings initiatives.
4. This release and discharge shall be binding upon the successors, heirs, estates, executors, administrators, and assigns of the undersigned.
5. I certify that, to the best of my knowledge, my child has no medical, psychological, or physical conditions that could interfere with his or her safety in Soccer Nights and other Vineyard Community Offerings activities and that I am willing to assume and bear the costs of all risks that may be created, directly or indirectly, by any such condition.
6. In the event of illness or injury, I hereby authorize representatives of the Cambridge Youth Collaborative, the City of Cambridge, the City of Medford, the Cambridge Police Department, Federal Management Company (“Fresh Pond Apartments”), Redemption Hill Church, Seven Mile Road, and the Charles River Church to act for me according to their best judgment in any emergency requiring immediate medical attention, and hereby grant the right to take appropriate action for my child’s health and safety and to obtain any necessary medical assistance. I understand that the directors & coaches of Soccer Nights and other Vineyard Community Offerings initiatives, or anyone associated with the Cambridge Youth Collaborative, City of Cambridge, the Cambridge Police Department, Federal Management Company (“Fresh Pond Apartments”), Redemption Hill Church, Seven Mile Road, and/or the Charles River Church will not assume responsibility for any medical or dental expenses incurred as a result of participation in this program, and those expenses shall be borne by me, as parent/guardian of my child, the registrant.
7. I give my consent to the Cambridge Youth Collaborative, the City of Cambridge, the City of Medford, the Cambridge Police Department, Federal Management Company (“Fresh Pond Apartments”), Redemption Hill Church, Seven Mile Road, and the Charles River Church to photograph, film, and/or use a photographic or digital reproduction of my child, to identify my child by name and/or to quote or record statements made by my child, for any editorial, promotional, or advertising purposes. I waive any right to inspect or approve the finished version(s). The Cambridge Youth Collaborative, City of Cambridge, the Cambridge Police Department, Federal Management Company (“Fresh Pond Apartments”), Redemption Hill Church, Seven Mile Road, and the Charles River Church and those who are authorized shall have the rights to reproduce, distribute, and display publicly, including on the Internet— photographs, film, videotape, statements, and quotes covered by this release, and to prepare derivative works. I understand that the Cambridge Youth Collaborative, the City of Cambridge, the City of Medford, the Cambridge Police Department, Federal Management Company (“Fresh Pond Apartments”), Redemption Hill Church, Seven Mile Road, and the Charles River Church are not responsible for unauthorized duplication or use by third parties.
8. I acknowledge that I have read and fully understand this Agreement and Consent Form and that I have signed voluntarily on the electronic Soccer Nights volunteer registration form.